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Saturday, August 15, 2009

Harris jail loses doc slot as federal litigation looms

In June of this year, the US Justice Department issued a findings letter to Sheriff Adrian Garcia about the Harris County Jail declaring that "Because of crowding, administrative weaknesses, and resource limits, the Jail does not provide constitutionally adequate care to meet the serious medical needs of detainees with chronic illness." Then, Lisa Falkenberg reported Thursday in the Houston Chronicle:

One day last month, Harris County Jail medical director Dr. Michael Seale arrived at the 1200 Baker St. jail and learned that about 100 detainees were lined up in the halls waiting to see a doctor.

Seale was told that one of two overnight doctors hadn't shown up. Seale then called UT Health Science Center, a longtime county contractor that provides the jail's doctors, and was told, according to sheriff's spokesman Alan Bernstein, that UT had decided to cut the doctor, for financial reasons.

It was a “shocking surprise,” to Seale and others at the sheriff's office, who were given no notice of UT's decision to cut a doctor the school added only a year earlier to meet growing clinic demands, Bernstein said.

“They didn't call in and say the doctor's not coming. … They said nothing,” said Bernstein, who spoke on behalf of Seale and Sheriff Adrian Garcia, neither of whom responded to my requests for interviews.

Bernstein said the sheriff's office now must pay $105 per hour for a doctor to fill the slot. He stopped short of accusing UTHSC of violating its contract, which doesn't require a specific number of doctors.

For UTHSC's part, its associate dean of Harris County programs, Dr. Stephen Brown, told me the reduction of jail staff shouldn't have shocked anybody at the sheriff's office, first because the school left word of the decision through UTHSC's on-site medical director, and second, because the school had warned the sheriff's office that the $3.1 million contract, approved by county commissioners this year, was woefully inadequate.

“We don't even cover our overhead,” Brown said. “It wasn't the amount we requested, nor the amount necessary to provide the care for the increase in volume that had occurred since 2006.”

Brown estimates that increase in jail clinics at 57 percent. He said UTHSC wanted $3.7 million, but agreed to the lower amount in a “good faith” compromise, with a vocal commitment from Seale that the contract would be renegotiated.

Doesn't it sound like things have gotten worse since the feds told Harris County in June that the jail "fails to provide detainees with adequate: (1) medical care; (2) mental health care; (3) protection from serious physical harm; and (4) protection from life safety hazards"?

At the time, the Justice Department told the county they wanted to work cooperatively to fix the problems but that USDOJ would sue them in federal court if they continued. Now, if the county isn't fully staffing its medical facilities, that gives the feds even more reason to step in.

The decision to contract for healthcare instead of providing it in-house was made long before Sheriff Garcia got there and bottom line: He can't approve a larger budget. It's up to the county commissioners court to pony up for jail health costs.

For that matter, even if the county sends inmates elsewhere instead of housing them in Houston, Harris County is still responsible for ensuring they receive adequate healthcare wherever they send them. That's the price you pay for operating a jail that's bigger than 19 states' prison systems. Including those housed elsewhere under contract, the Harris County Jail incarcerates about the same number of people as all the state prisons in Massachusetts.

Bottom line: Mass incarceration is a pay to play activity, and at the local government level you don't get to play with borrowed money. Spending on inmate health is a big part of that expense, and if the commissioners court won't voluntarily foot the bill then the feds are poised to make them.

22 comments:

Actually, they passed a recent spot inspection. Sheriff Garcia is doing a much better job at maintaining the jail, so the physical problems with the facility are not a problem. The scattering of prisoners to other counties has helped as well. This doctor thing doesn;t seem like his fault, really.

We're still incarcerating too many people, but I think things are actually improving from when Thomas was in charge.

Actually, they passed a recent spot inspection. Sheriff Garcia is doing a much better job at maintaining the jail, so the physical problems with the facility are not a problem. The scattering of prisoners to other counties has helped as well. This doctor thing doesn;t seem like his fault, really.

We're still incarcerating too many people, but I think things are actually improving from when Thomas was in charge.

8/15/2009 02:50:00 PM---------------------------------This is not about Adrian Garcia. He is an excellent Sheriff and just what we needed after Tommy Good Ole Boy Thomas, however, the issues at the jail are much, much bigger than Garcia.

The problems at Harris County are caused by the fact that the county commissioners, jail staff and affiliated organizations have no clue how to run a 10,000 inmate jail system, they just dont.

Adrian Garcia's experience as a Houston Cop and city councilman does NOT qualify him to run a jail. The problem here is that they wont hire people with detention/corrections professional experience to run it. Relying on Harris County good ole boys to run this jail system will continue to doom it to failure.

Yes, Garcia has done a lot but not nearly enough and NO it's not all his fault.

Had you read my entire post and tried to understand it, you would have noticed that I addressed the whole issue not the latest State Jail Commission report. No one's after you, settle down a little bit.

Anonymous said...

There's a big political fight brewing between their sheriff and commissioners court. Harris County will sacrifice their jail in order to get back at this sheriff.

The issue continues to be jail overcrowding, and how resources are spent to accommodate inmates who are subjected to these conditions.

The controversy over jail overcrowding should bring to light issues that surround the basic structure of bail, how bail is determined, who should be given bail, and the circumstances of such action.

There’s always discussion about tax dollars and where is the money going to be spent, and as you have stated they can’t borrow it at the local level.

The County doesn’t have an endless supply so consideration should be given anywhere possible to save where you can and spend where you have to, even on tough issues.

The bail bond industry in Harris County and in general seems to get a bad rap from some because they have the misconception that bondsman are somehow connected to the government purse.

The bail bondsman represents private enterprise, something that is rapidly fading away in this country. They take nothing from government coffers and when they fail to perform they pay in substantially. On several occasions the bloggers here have indicated the need to utilize the services of Pretrial Release, including you Scott.

The problem with this line of thinking would seem obvious to anyone who looks at the issue from a logical perspective, certainly if looked at and measured by where valuable tax dollars are being spent needlessly.

Scott has made the statement that in his opinion a solution to jail overcrowding, (July: Can “czar” help Harris jail overcrowding) is to convince judges to expand the use of personal bonds instead of requiring bail for low level offenses.

Government would like to give the appearance of being responsible with taxpayer money so personal bonds are typically a product of the Pretrial Release Agency. Judges could give a personal bond without the need of the overly funded Pretrial Release Agency and shoulder the responsibility alone at the risk of being persecuted publicly in the next election when the opponent points to how many criminal defendants absconded and failed to appear. The Judges in Tarrant County just got a taste of that last year from their local news8 reporters, in what I’m sure they felt was an endless eye opening commentary. After seeing and reading the same report, Commissioners Court Officials in Tarrant County stated that they felt revisiting how they utilize Pretrial Release should be in order.

The fact is practically all low level offenses are given a (free bond) through the Harris County Criminal Courts and Justice of the Peace Courts and that has been the practice for years. This is done predominantly through the Harris County Pretrial Release Agency, but personal bonds are also part of the equation. Their appearance ratio has never been as good as that of private enterprise, nor are they ever held accountable. In fact the only true measurement for a taxpayer funded bail agency is their non-appearance, since that is the only part of that equation that holds any significance.

In spite of the systems failure to perform as well as private enterprise and the fact that they are not held responsible in any way for their failures, the true question is why are they needed for low level offenders? The bonds for theses offenders are set very low to begin with and typically these defendants make bail very quickly anyway, they are the least likely to abscond and do not represent the population that overcrowds the jail. Yet huge portions of tax dollars are spent to secure the release of these defendants.

Let private enterprise do their job at no cost to taxpayers. Pretrial Release could work hand in hand with private enterprise on the more serious cases and split the bonds so that some accountability is still in place. If a low level defendant cannot make bail within 48 hours then by all means let Pretrial petition the court. Continue to release the class C misdemeanors out on personal bonds, (even though the system is completely failed), who knows if injected with a little responsibility and common sense there might be room to take care of these defendants lawfully as well, and bad check writers won’t just get a free ride. Lower the bonds on drug cases where there was no violence or weapons involved. Stop the Pretrial Release Agency drug testing of the presumed innocent, which again costs massive tax dollars to fund and only serves to impact the jail. Last but not least take a ton of taxpayer money that has not been spent wisely and reallocate it to clean up the jails health issues.

What the hell is all this "private enterprise" bullshit. The United States is the only major country that allows businesses to profit off of whether or not a person is incarcerated. Some things should not be "private," especially when that "private enterprise" greases the palms of every judge in town by way of campaign contributions so they'll continue to require bails.

Nothing "private" about a business that only exists because government employees that it bribes sends business their way.

I guess then you would prefer the government to decide who gets out of jail and who does not.

Socialism isn’t considered to be a strong platform to stand on in a free society. Ask someone from Iraq or Iran, try China or Russia, or how about Mexico; ask those folks what the safeguards are for the accused. The last two people I got out of jail from Saudi Arabia were ecstatic; they couldn’t believe getting out of jail was so easy. Their government run system provides bread and water and darkness, at least that is what they expressed to me.

Bail bondsmen hold very little political weight locally. As a group statewide they do what they can to try and protect their interests on the State level, and they do that very inadequately. If they were actually able to have some input the jail would not be overcrowded.

But what the heck, trash the 8th amendment. While your at it go wave your health care flag too, because what they are getting in the Harris County Jail will be very close to what your going to get when the government controls that too for you.

I’m not sure what your beef is with bondsman, the originators of our constitution were interested in safeguarding the accused, and if Pretrial Release were doing what they were set up to do a whole lot of indigent people would be getting a fair shot at defending themselves too. Instead, since they are an ever growing government agency that needs more and more tax dollars, their focus turns more toward finding the accused guilty before they have even had an opportunity to face their accusers through drug testing and government requirements that infringe upon their jobs and day to day lives. Life, liberty and the pursuit of happiness are things that those who are by law are presumed to be innocent should have the right to attain.

If Harris County wants to play this 'tough on crime' BS,......then 'let them pay'!! I know that this jail system isn't FULL of murderers, and rapists. When you fill up your jails with people accused of PETTY, non- violent crimes, you need to be prepared to PROPERLY care for them in every aspect!! Shame on you Harris County!! First for overcrowding the jail system with 'petty' offenders. Second for not properly providing housing and medical/ psychiatric services. And last, but not least, for complaining about it, and blaming UTMB!! Don't get me wrong, I'm not defending UTMB........they are a tragedy and a farce at the same time as far as correctional medical care goes. But, they(UTMB) are not responsible for your mess!! "you made YOUR bed; now LIE in it"!........andy

I guess then you would prefer the government to decide who gets out of jail and who does not. ---------------------------------THAT'S HOW HARRIS COUNTY OPERATES NOW. WHERE IN THE HELL HAVE YOU BEEN? NO ONE GETS OUT OF JAIL PRE-TRIAL WITH BONDING PRACTICES AND POLICIES IN HARRIS COUNTY...NO ONE!

Actually all class C misdemeanors are released on PR bonds, all of them. Many of these defendants fail to appear, but I have no problem with this practice because they are class C misdemeanors, and because they are released without utilizing a taxpayer funded agency.

Practically all, if not (all), 1st offense Class B Misdemeanors are released through Harris County Pretrial Release, and many Class A Misdemeanors are released as well. The problem that I have with this practice is that taxpayers are paying a ton to release defendants who would get out anyway because the bail is set low. It simply doesn’t make sense, why pay a ton of money for something that’s not needed in the first place.

I agree that those with high bail are not getting out; I agree that government is controlling who can and can not get out. I’m saying many of these bonds could be lowered and the defendants will appear, especially if someone is actually responsible for their appearance. Bondsmen are just as concerned with losing $500.00 as they are $5000.00 or more.

Finally I’m saying that if the government wants to be in the bonding business; and spend tons of tax dollars to be in the bonding business, the exact opposite of private bail which doesn’t cost taxpayers a penny, then let the money account for something, let them split those bonds that are extremely high with private bondsmen. That would make it much more possible for families to post bond for the accused, the government can keep their hat in the ring so their federal funding doesn’t dry up for their Pretrial Prodigy , and the bondsman is still on the hook; then there is at least someone financially responsible to make sure the defendant still appears.

All of these suggestions would help ease the overcrowding and it would be done responsibly. Once the jail numbers are lowered then the tax dollars that are saved by not spending needlessly could be used to address the health problems.

As far as where I have been, I have been smack in the middle of this issue for years and years, probably longer than you have been on this Earth.

I’m hoping a few people will begin to use some simple common sense.

Just because the government wants to be in the bonding business doesn’t mean they are doing an effective job, because they do not and never have.

Government bureaucracy is rarely, if ever, the answer to anything other than their own job security and taxpayers always have to provide for it. What’s even more amazing is that this is the opinion of the vast majority of tax payers, but they do not understand how all this works to benefit only the government.

It’s simply not their money to just play with and it should be stopped.

This Agency is very heavily funded and was originally set up to safeguard against discrimination of the indigent, which is not at all what it does. It is a government bureaucracy and like all government it continues to grow, and like all government it will always provide skewed statistics to show why it needs more taxpayer money.

It’s not rocket science, its basic math, and real issues that have not been addressed for years. It is simply not that difficult to fix the jail problem. If all of these people are in jail because they are a flight risk, then let those that are financial responsible take the risk, within reason, for everyone involved, and they will get the defendant to court, and that serves justice.

The claim can be made that they are also a danger to the public but if bail is set so high that nobody can afford to take the risk then the Federal Courts will simply start mandating releases and no one will be responsible for anything, it just doesn’t make sense.

As far as the nonsensical and utterly ridiculous claims that others are making about bondsmen controlling anything, that theory is about as far as the East is from the West to being truthful.

Bondsmen would dearly love to be instrumental in solving some of these issues, these people are in jail, not out, and that doesn’t benefit a bail bondsman in the least.

Please someone show me where I’m wrong here, and leave out the sarcasm.

Ask any bondsman, he will tell you “air traffic controllers are wimps”. If the job were simply about making money and being a fat cat, a lot of bail bondsman with bloodshot eyes would have gotten out long ago; every one of them asks themselves why they got in the business at all. They scratch and earn a rough living every single day, 24 hours a day, 7 days a week, Christmas and holidays, or they do go out of business. Keeping track of criminal defendants and getting them to court is anything but easy, and yes some don’t want to go, but we get them to court anyway. I don’t care much for morticians, politicians, electricians, or technicians, but somebody has to bury us, somebody has to govern, and somebody has keep my lights on and fix my computer. The jail is overcrowded! I’m a bail bondsman, how can I help you.

3:31/2: Bondsmen aren't free to the public, of course, when their business model requires filling up the jail with every defendant who doesn't use their services and the public must pay for their incarceration. If it weren't for the increased use of bail at the Harris jail over the last 15 years, the jail wouldn't be full and the county wouldn't be leasing beds in Texarkana.

I'm sure as a bail bondsman you do like the status quo because it lets you make money off the system. But you're ignoring the costs that system creates for taxpayers that basically subsidize your profits. "Free" things that cost more money in the long term aren't really a good deal.

I respect your opinion Scott, in almost every subject you write. I hope your efforts in bringing about discussion of matters concerning the Criminal Justice System, and your personal contribution, bring about much needed changes.

This subject could truly be too close to home for me.

If I were able to affect anything, which I am not, it would be to have our country revisit perspectives of how to properly address drugs. I feel the answer is through treatment and not incarceration; I feel this would have the greatest impact and serve the masses.

As far as private bail, our considerable contribution to government coffers when we fail, and our service at no cost to taxpayers VS government bail and their focus not being utilized in a manner that would be of much more benefit to taxpayers than the role they currently play, I must respectfully disagree.

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